| NPI | 1477938363 | 
|---|---|
| Doing Business As | YOUNG ADULT THERAPY | 
| Entity Type | Organization | 
| Authorized Contact | GAIL RACHEL LALK Licensed Professional Counselor 973-525-7797  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NJ 37PC00448600)  | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NJ 37LC00220900)  | 
| Enumeration Date | 2015-07-21 | 
| Last Update Date | 2015-07-21 |